DIANA ELIZABETH GWINN


Address: 16405 Ne Fargo Cir, Portland, OR 97230-5513
Phone: 5034847287

DIANA ELIZABETH GWINN (NPI# 1386122687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386122687
Entity Type Individual
Full Name DIANA ELIZABETH GWINN
Credential DD1
Practice Address 16405 Ne Fargo Cir
Portland
OR 97230-5513
Practice Telephone 5034847287
Practice Fax Number 5032105974
Mailing Telephone 5034847287
Mailing Fax Number 5032105974
Enumeration Date 2018-07-30
Last Update Date 2018-07-30
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 311ZA0620X Custodial Care Facility
Specialization: Adult Care Home
10465 OR Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
OR 500745787 05

Office Location

Street Address 16405 NE FARGO CIR
City PORTLAND
State OR
Zip Code 97230-5513

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932687233 Timisha K Wilson Social Worker 12505 Ne Halsey St, Portland, OR 97230 2018-07-30
1356828768 Sally Gail Logan Pharmacist 5725 Ne 138th Avenue, Portland, OR 97230 2018-07-27
1063937951 Marley Elizabeth Small Counselor 1507 Ne 122nd Ave., Portland, OR 97230 2017-08-11
1447771316 Shadab Nasreen Aijazi Pathology 5220 Ne 122nd Avenue, Portland, OR 97230 2017-06-30
1104378199 Derek Andrus Pharmacist 5717 Nw 138th, Portland, OR 97230 2016-10-26
1164972675 Rachael Anderson Adult Companion 423 Ne 160th Ave #11, Portland, OR 97230 2016-10-07
1750837597 Providence Elderplace Assisted Living Facility 16430 Ne Hoyt St, Portland, OR 97230 2016-08-31
1649622473 Sara Mcgroarty Counselor 17710 Ne Halsey Street, Portland, OR 97230 2016-07-05
1346699949 Steven D Stanton Counselor 1022 Ne 181st Ave, C1, Portland, OR 97230 2016-06-06
1215390091 The Wallace Medical Concern Clinic/Center 18139 Ne Couch Street, Portland, OR 97230 2016-03-30
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Taxonomy Information

Taxonomy Code 311ZA0620X
Grouping Nursing & Custodial Care Facilities
Classification Custodial Care Facility
Specialization Adult Care Home

Taxonomy Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801403910 Baseti Gelgelu Custodial Care Facility 2055 Sw 79th Ave, Portland, OR 97225-3805 2020-09-23
1801402946 Demeti Gelgelu Custodial Care Facility 2010 Sw 79th Ave, Portland, OR 97225-3806 2020-09-22
1306212295 Amer Filipovic Custodial Care Facility 2708 Se 111th Ave, Portland, OR 97266-1106 2015-08-14
1740410356 Paradise Adult Foster Care Incorporated Custodial Care Facility 1356 Se 172nd Ave, Portland, OR 97233-4702 2009-07-16
1013153659 Ileana Kerezsi Custodial Care Facility 3519 Se Cora Dr, Portland, OR 97202-3332 2009-01-04
1639291131 Casa, Inc Custodial Care Facility 741 Warren Ave, Portland, ME 04103-1007 2007-04-04
1295043982 Lifeworks Northwest Custodial Care Facility 14600 Nw Cornell Rd, Portland, OR 97229-5442 2010-09-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1447808100 Remelita Loftin Custodial Care Facility 2297 Minnesota St, Eugene, OR 97402-6244 2019-08-27
1316506397 Stephenie Jo Murdock Custodial Care Facility 2355 Baker St, Baker City, OR 97814-2541 2019-06-12
1346707296 Dastu I Ahmat Custodial Care Facility 55 Nw 23rd St, Gresham, OR 97030-2640 2019-02-27
1558837781 Larisa Kravchuk Custodial Care Facility 805 Fir Cone Dr Ne, Keizer, OR 97303-4328 2018-10-15
1376071464 Mckenzie Living, Incorporated Custodial Care Facility 2621 Lone Oak Way, Eugene, OR 97404 2017-06-01
1598292997 Gateway Assisted Living, Inc. Custodial Care Facility 611 N Cloverleaf Loop, Springfield, OR 97477-1188 2017-05-16
1841727617 Gateway Gardens Assisted Living, Inc. Custodial Care Facility 178 Commons Dr, Eugene, OR 97401-8923 2017-05-11
1609314509 Catherine Jensens Foster Home Custodial Care Facility 108 Ash Drive, Rogue River, OR 97537 2017-02-10
1932647211 Lynn Marie Bartlett Custodial Care Facility 4286 Camellia Dr S, Salem, OR 97302-2710 2017-02-07
1568906477 Radiant Care Afh 'llc' Custodial Care Facility 52 Nw Birch Ct, Warrenton, OR 97146 2016-12-12
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Competitor

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City PORTLAND
Zip Code 97230

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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